一站式杂交技术在治疗复杂型主动脉缩窄中的应用  

One-stage hybrid technique in the management of complicated aortic coarctation

作　　者：王亮[1] 常谦[2] 田川[2] 魏以桢[2] 韩超[2] 裴华伟[2] 

机构地区：[1]川北医学院附属医院小儿外科,四川南充637000 [2]中国医学科学院北京协和医学院阜外心血管病医院心血管病研究所血管外科中心

出　　处：《心血管外科杂志（电子版）》2014年第2期70-73,共4页Journal of Cardiovascular Surgery(Electronic Edition)

摘　　要：目的探讨一站式杂交技术（ one-stage hybrid technique ）治疗合并其他心血管疾病的复杂型主动脉缩窄的临床应用价值。方法回顾性分析2011年1月至2013年9月阜外医院血管外科中心收治的复杂型主动脉缩窄15例，均为男性，平均（26.93±9.84）岁（13～46岁）。全部患者均在杂交手术室一期完成手术，先经股动脉置入球囊扩张支架，然后正中开胸，常规体外循环下行Bentall等手术。结果15例手术均成功完成，术后上下肢压差（8.67±4.81） mm Hg。同期外科手术包括Bentall 手术7例，主动脉瓣置换术4例，单纯二尖瓣置换术1例，二尖瓣成形术2例，室间隔缺损修补1例。体外循环时间（67.38±19.67） min，支架长度（37.29±3.34）mm，ICU时间（42.35±24.89）h。随访3～24个月，院内及随访无死亡病例，无支架移位等并发症。结论一站式杂交技术治疗复杂型主动脉缩窄安全、有效，住院效果满意，早中期随访结果良好。由于样本量较少，随访时间较短，尚需进一步随访评估远期疗效。Objective To evaluate the effective of one-stage hybrid technique in the management of complicated aortic coarctation in adolescents and adults .Methods To analysis 15 adolescents and adults retrospectively with complicated aortic coarctation from January 2011 to September 2013 in the aortic surgery center of Fuwai hospital .They were all male and the average age was 26.93 ±9.84 ( 13-46 ) years old .They were all operated in one-stage in the hybrid operation room , and balloon-expandable stents were transplanted firstly .Then surgeries were operated sternotomy through cardiopulmonary bypass ( CPB ) .Results All the procedures were completed successfully ,as 7 Bentall procedures ( include 1 semi-arch replacement and 1 mitral valve replacement ) , 4 aortic valve replacements , 1 mitral valve replacement , 2 mitral valve repairs , and 1 VSD repair were operated simultaneously .The average blood pressure drop of upper and lower limbs was ( 8.67 ±4.81 ) mm Hg post-operation.The CPB duration was (67.38 ±19.67 ) min and the length of ICU stay was (42.35 ±24.89 ) h.The average length of stents was (37.29 ±3.34 ) mm.During in-hospital and follow up (3-24 months),there were no complications .Conclusions It is secure and effective of one-stage hybrid technique in the management of complicated aortic coarctation in the adolescents and adults for the satisfactory in-hospital and follow up results ,but further follow up is needed for the late results .

关 键 词：主动脉缩窄 一站式 杂交 支架 

分 类 号：R654.3[医药卫生—外科学]